Organization
LASSEN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFFEN NIELS LASSEN DDS (DENTIST/SOLE MEMBER)
(208) 419-6156
Entity
Organization
Contact information
Practice address
4120 QUEST DR, EUGENE, OR 97402-8768
(541) 688-7278
Mailing address
4120 QUEST DR, EUGENE, OR 97402-8768
(541) 688-7278
(541) 334-6604
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004179098
UNITED CONCORDIA
OR
01
—
1750811485
REGENCE
OR
01
—
1965981
CIGNA
OR
01
—
3771529
PACIFIC SOURCE
OR
05
—
500757214
—
OR
01
—
P00001209592
ODS
OR
Enumeration date
04/10/2019
Last updated
04/10/2019
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